Fanderclai, Keith - (Pharmacist)
Saint Louis, MO 63131
License# : 1999140906 - Issued on : 12/10/1999
Doing Business As :
| Licensee Name: | Fanderclai, Keith |
| Profession Name: | Pharmacist |
| Licensee Number: | 1999140906 |
| Expiration Date: | 10/31/2016 |
| Original Issue Date: | 12/10/1999 |
| Address: | |
| Address Con't: | |
| City, State Zip: | Saint Louis, MO 63131 |
| County: | St. Louis County |
| Practitioner DBA Name: | |
| Classification: | Medication Therapy Services |
| Current Discipline Status: | None |
Board of Pharmacy
3605 Missouri Boulevard
P.O. Box 625
Jefferson City, MO 65102-0625
573.751.0091 Telephone
573.526.3464 Fax
800.735.2966 TTY
800.735.2466 Voice Relay
MissouriBOP@pr.mo.gov
http://pr.mo.gov/pharmacists
